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近足月孕妇阴道直肠群 B 链球菌定植情况,埃塞俄比亚西南部。

Group B Streptococcus Recto-Vaginal Colonization in Near-Term Pregnant Women, Southwest Ethiopia.

机构信息

Corresponding Author, Obstetrician and gynecologist, Department of obstetrics and gynecology, Jimma Institute of health sciences, Jimma, Ethiopia,

Obstetrician and gynecologist, private hospital, Dessie, Ethiopia,

出版信息

Ethiop J Health Sci. 2020 Sep;30(5):687-696. doi: 10.4314/ejhs.v30i5.7.

Abstract

BACKGROUND

Group B Streptococcus (GBS) is recognized as an important cause of maternal and neonatal morbidity and mortality. Maternal vaginal carriage of GBS (Streptococcus agalactiae) can lead to vertical transmission to the neonate at the time of delivery. However, little is known about its prevalence, predictors and antibiotic susceptibility pattern in Jimma, Ethiopia. This study assessed the prevalence, antimicrobial susceptibility pattern and determinants of GBS recto-vaginal colonization among near-term pregnant women.

METHODS

A cross-sectional study was conducted from May to August 2015 at Jimma University Medical Centre in Southwest Ethiopia. Data through questionnaire and GBS isolates from vaginal and rectal swabs were collected. Antimicrobial susceptibility testing was performed.

RESULTS

The overall prevalence of GBS colonization among near term pregnant women (35-37 weeks) was 16.3% (22/135). The majority of GBS isolates were sensitive to Ampicillin and Penicillin G with 95.5% and 90.1%, respectively. Erythromycin and clindamycin were resisted by 50% and 40.9% of the isolates, respectively, whereas gentamicin was resisted by all isolates. GBS colonization was significantly associated with a history of preterm delivery (PTD) (AOR: 6.3, 95% CI: 1.42, 28.3) and history of urinary tract infection (UTI) during current pregnancy (AOR: 6.4, 95% CI, 1.95, 21.1).

CONCLUSION

Our study indicated that one among six near-term pregnant women had recto-vaginal GBS colonization. In places where universal screening is not feasible, selective screening for factors particularly history of PTD and UTI during current pregnancy may be a reasonable option. Antibiotic susceptibility testing should be performed while using Erythromycin, Clindamycin or Gentamicin.

摘要

背景

B 群链球菌(GBS)被认为是导致母婴发病率和死亡率的重要原因。母体阴道携带 GBS(无乳链球菌)可导致分娩时垂直传播给新生儿。然而,在埃塞俄比亚吉马,人们对其流行率、预测因素和抗生素药敏模式知之甚少。本研究评估了接近分娩的孕妇中 GBS 直肠-阴道定植的流行率、抗生素药敏模式和决定因素。

方法

2015 年 5 月至 8 月在埃塞俄比亚西南部的吉马大学医学中心进行了一项横断面研究。通过问卷和阴道直肠拭子收集数据和 GBS 分离株。进行了抗生素药敏试验。

结果

在接近分娩的孕妇(35-37 周)中,GBS 定植的总体流行率为 16.3%(22/135)。大多数 GBS 分离株对氨苄西林和青霉素 G 敏感,分别为 95.5%和 90.1%。红霉素和克林霉素分别有 50%和 40.9%的分离株耐药,而所有分离株均耐药。GBS 定植与早产史(PTD)(AOR:6.3,95%CI:1.42,28.3)和当前妊娠期间尿路感染史(UTI)(AOR:6.4,95%CI,1.95,21.1)显著相关。

结论

我们的研究表明,六分之一的接近分娩的孕妇有直肠-阴道 GBS 定植。在不能进行普遍筛查的地方,针对特定因素(特别是当前妊娠期间的 PTD 和 UTI 史)进行选择性筛查可能是合理的选择。使用红霉素、克林霉素或庆大霉素时应进行抗生素药敏试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a90/8047261/151f250e9f17/EJHS3005-0687Fig1.jpg

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